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Hi all,
This is really just some venting. I'm not sure anymore how to find a competent, confident and qualified caregiver. I have tried a few agencies in my area that had good ratings and am getting pretty awful people coming in to help. They don't have the intelligence, initiative or common sense to solve any issues on their own. I almost can't believe how bad they are and there is no way I'd feel comfortable leaving my Dad alone with some of them. I hate to say this but it's almost like they have some kind of learning disabilities. I have contacted the agency managers multiple times and nothing seems to be done about it or another unskilled person is sent to us.



It's so depressing. They are asked to do VERY little but what they are asked to do is necessary.



I don't know what to do, at this point.



Thanks for letting me vent :)

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I too was a little taken back when I learned that the title of “caregiver” did not translate to any actual professional training or licensing. Various home health agencies were all too eager to send over a “caregiver” for $40 to $50 an hour with a 4 hour minimum… only these “caregivers” were not CNAs or certified Home Health Aides… just rando kids that applied & were willing to show up. I found the same level of training (lack there of) occurring in the local Board & Care Homes. Before placing a loved one, ask the support staff some basic medical questions like “what do the numbers on a blood pressure reading mean, what are the signs of stroke?” etc I did that… my dad is still in his condo as a result.

Now I appreciate that there is a major labor shortage… inverted productivity due to more dependents in the population than producers… I am totally aware that our elders cannot comprehend the economic hopelessness & brutality anyone under age 50 is currently experiencing. So if a fast food restaurant is offering $18-$20 an hour to start, why would anyone of sound mind work for $15 to wipe the butts of angry old people.

The solution to my particular situation was hiring private pay caregivers. I’ve said this before - I am literally operating a small business specifically for my fathers in home care. Even with a background in business management/operations it’s complicated & exhausting. I really wish I could have utilized an agency, but the quality of care was in fact abysmal. This is not an attack on caregivers in a personal capacity, but rather the applicable care that is or is not provided.

I interviewed over a dozen applicants that I found mostly through local churches & work connections. I settled on 3 part time caregivers & scheduled them in ways that all can have 2 or 3 other clients. Only one was an actual CNA. For the others I purchased a used intro to nursing textbook that I keep in my dad’s place. Because I had 6 years of hands on wound & cancer care, etc from my previous forced family caregiver experiences ( plus I’m a licensed Holistic Health Practitioner & licensed Cosmetologist among other stuff) I did serious hands on training for my hired caregivers. By training them myself I was able to get the sort of care my father truly needs.

I looked into CNA licensing & here in California there are multiple programs available that will fully pay for someone to attend classes & become a CNA. The entire process can take as little as a month. When I think about the tens of thousands of dollars & years of education it took me to obtain my professional licensing & certifications… Now the government will pay for you to go to school for a few weeks & you can come out debt free earning more than Hairstylist with 20 years in the industry.

I do offer compensation that is far above any potential competition. My girls are paid every single week at $25 a hour to start, all food & beverages are covered during their shifts, paid Birthday Day off, are allowed to bring their pets with them to work & a holiday bonus. They have all holidays off & get plenty of little extras to show they are valued because it’s damn hard work. But they do not get healthcare benefits or paid time off. Now my one caregiver that’s a CNA frequently asks for pay raises but I’ve told her no & she free to find better pay - she’s still around… words gotten out in my dad’s condo community & I have people approaching me to ask to work for us. Turns out sometimes when you treat people fairly & respectfully, they will respond in kind. Not always, but the ones you actually want around will.

I truly believe the western world is currently in a crisis of caregiving that has only begun to emerge. The costs are simply too high & the only real solution any one can provide is financial destitution that is ultimately designed to obliterate the existence of a middle class for the direct benefit & profit of the investment class.
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I tried taking care of my mom. I did try. It is so hard. I tried my best to kept her happy and safe at home. I felt so bad and guilty when I had to move her.,
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OP, perhaps you didn’t reread your comments, but they do seem very very judgemental. The ‘quality of care’ may be abysmal by your standards, but the ‘quality of careGIVERS shouldn’t be judged like this. You want them to be ‘competent, confident and qualified’ when they are doing a boring underpaid job? Would you do it yourself? Or would you require better pay? They don’t have ‘intelligence, initiative or common sense’? And you say ‘they are asked to do VERY little’? Perhaps you should do it yourself if it’s so trivial.

What are you doing to build better relationships with the unfortunates who work for you? OK this was just a vent, but if this is how you treat them, it wouldn’t be a surprise if they don’t try too hard!
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Abby2018 Dec 4, 2023
So you choose to turn this on the OP when she complains about the lack of competent care for her dad? They applied for the job they're performing.....and no matter what the circumstances are, there is an expectation to follow through with at least some resemblance of competency. I understand that CNA's are underpaid, but since she is going through an agency, she has no control of that. As far as doing this herself because it's "so trivial"....I'm willing to bet she's done it all countless times......that's why she needs some help. Maybe you should reread your comments, as you appear to be very judgmental yourself.
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As an old person who MAY need help in the foreseeable future, the lack of caregiver quality is pretty scary and very depressing. Other than through an agency, or blind luck(!), how do ordinary people without connections to the healthcare industry go about finding a competent paid caregiver if we need one and are able to pay a competitive wage? Craigslist doesn't seem like a very good idea!
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Hothouseflower Dec 5, 2023
I posted on NextDoor. Of the five we had over the course of this year, three were great. The other two we had to let go. One was not reliable and the other’s personality was not a good fit with my mother.
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My parents had wonderful caregivers when they were still living at home. One actually visits my parents in the NH once or twice a mont on her own time.

I grew close to her during the year she worked for my parents. Her birthday was last week and I'm taking her out for lunch tomorrow and will give her a little gift.

I have met so many kind, compassionate people these last few years who were involved with my parents' care. The world is a better place because of people like these.
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Honestly, I think agency caregivers are worse than private ones. The best thing to do is ask as many people you can for personal recommendations. If your community has a Facebook page or a NextDoor page, that's always a great way to find them.
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What exactly are you expecting them to do that they are not?
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I was an in-home caregiver for 25 years and I now operate my own homecare business.

Here's how you get quality caregivers. Hire privately and offer quality pay. Not te insult wages that are usually offered.

Or if you're going to use a homecare agency, the first question you should ask is how much of what the agency collects for a caregiver actually gets paid to the caregiver. The answer to that should be at least 50%. If it's not then go with a different agency.

Homecare is mind-numbing, back-breaking drudgery work. The work is lousy and so is the pay. That's why the turnover rate is so high in caregiving. The people who usually do this line of work are either students who are going to move onto greener pastures, or it's people who couldn't get a better job.
You want quality, competent caregivers? It's going cost you. I did private care for a long time and named my price. Either the clients met my price and I worked for them or they did not and I moved on.

Please do not buy into the complete nonsense of it being "rewarding" and making a "difference" in people's lives.
That's the BS agencies tell their homecare workers because they won't do right by them.

Personally, I treat my people right because I know how it is and I'm not greedy. The same cannot be said for other agencies.

So if you want good help, pay for it. That's how you get it.
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NeedHelpWithMom Dec 4, 2023
Even if it is rewarding for some people, low pay for a very tough job isn’t going to pay the bills! It also isn’t worth being completely stressed out and not being compensated fairly for your work.

50 percent sounds fair to me but are there any agencies that can afford to do this? What is the overhead costs of running an agency?

I would think that if more people are satisfied with their services, then the agency has more clients, which results in more money. It boils down to if it is sustainable for them in regards to their overall overhead expenses.
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I have great experience with aides who do contract work for the better assisted living places in my area.

With the exception of a few, most of my father's caregiver's have been highly professional, friendly and caring beyond anything I could ever imagined. I thought I was a good person. These people put me to shame. However, I have run across some who are totally lazy, one who was naturally mean-spirited, and one who was apparently dishonest. Also, one who was great in all respects except they talked way too much! Very annoying.
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BurntCaregiver Dec 4, 2023
@Lisa

I really don't think you are in any position to call anyone annoying.

How would you have experience with private aides who contract themselves out to assited living facilities? You never did this kind of work so how wouls you know?
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I was fortunate enough to have mostly good caregivers that came to our home to help care for my mother.

There were a couple who didn’t do as good of a job. When this occurred, I didn’t hesitate to call the agency and tell them that I wasn’t satisfied with their service.

When the care was good, I requested that they send a particular caregiver to my home on a regular basis.

It was important to me that my mother received the best care possible and that my mother was comfortable with her caregiver.

The agency that I worked with was grateful for the feedback and took my review of their services seriously.

I don’t feel these workers are paid enough. They have a tough job, so there can be a high turnover rate.

I did whatever I could to ensure that I kept good caregivers.

I kept their favorite snacks in my home for them to enjoy. I told them to help themselves to the same lunch or dinner they served to my mom. I had a stash of coffee, tea and other beverages on hand for them to drink.

They were kind to my mother and she was grateful for their help. Mom was always cooperative with them about bathing, etc. So they had a harmonious working relationship with my mother.

I am not sure how much they were trained by the company but several of the caregivers who came to our home took care of their own family members and I felt confident in their abilities to care for my mother.
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Our family was beyond blessed by the excellent caregiver we hired privately. She was part of a loosely organized group of mostly older CNA’s who’d grown frustrated working in nursing homes and being told to “hurry up” on tasks like feeding or dressing a resident, when they preferred to go at the resident’s pace and show kindness and patience. One lady oversaw the hiring but each one set their own rates and agreed to the job and hours. We heard of them through word of mouth and couldn’t have been more pleased.
That said, our adult son with a brain injury and many other medical issues has worked in the same job for 13 years in a popular fast food place. When he started as a teen, it was viewed as a hard place to get a job and rather a privilege to work there. In the past several years, we’ve watched as they’ve also grown desperate for employees and have accepted awful laziness and incompetence from the new hires. People quit by just disappearing. We feel bad for anyone having to hire in the current culture.
My mother spent four years in a nursing home and received compassionate and throughly competent care. But I’m well aware this was pre everyone being constantly attached to a phone and the social media obsession. I still fully know nursing home care is often necessary, but I fear what it must frequently be like now
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BurntCaregiver Dec 4, 2023
@Daughter

I worked with a crew of caregivers like you described for years. Highly experienced private duty aides.
If I needed some extra help on a job, I'd bring a couple in. Same if I was looking for some hours or someone needed help.

It will cost you though. None of us ever came cheap. As for people quitting a job by just disappearing. The new work ethic of people is not the workers' fault. It is the employer's.

Businesses and companies have zero loyalty to their workers today. It doesn't matter how good a worker is or how much they do. They don't want to offer decent, livable wages and often good workers get punished for being good workers because the company takes advantage of them. If the company decides to downsize you're out. If they feel like moving somewhere else, you're out and you're lucky to get that two week's severance. If they hear the word "unionizing" employees you're out.

So where there is no loyalty for the proliteriat there will be none for the employers. When there is no loyalty, there is no work ethic. That's not the fault of the workers. The workers are only now starting to behave the same ethics as their bosses have since day one. Why should they not?

When you're good to the help, the help is good to you. That's why companies like Costco have such good business. That's why their worker's are loyal to them and they don't have a high turn over rate among employees.
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As an employer for many years since 1983 (in the graphic arts / advertising / branding industry) I can tell you that once we entered the 2000s we never found the quality of people like we did in the earlier years. They were dismal problem solvers and seemed to have 0 common sense or initiative. So, we got used to training up and investing in (and taking risks with) the mediocre ones we did hire and the same will need to be true of in-home aids. If you find a reasonable one you should consider teaching them certain things yourself, if possible.

I went through at least 3 agency aids to eventually find 1 that was with us for 6 years until she retired. She was awesome and worth the work to find her and we made sure to give her enough hours to incentivize her to keep requesting us. After that, it was a parade of clueless people who looked at their phone every other second and had no sense that we were a paying client with expectations. There is still a labor shortage combined with a mass of Boomers needing more services, plus the govt is being stoopid about letting people into this country legally to work and have better lives.

For anyone who needs to hire agency aids, you must request people who are experienced in working with people with dementia, and any other specifics your LO needs tending to. But good luck with that. I would now go so far as to have them watch Teepa Snow videos so that they can have some understanding of what they're doing.

As for how much they're paid... like teachers, if you raise their rate it just gets passed on to us consumers since healthcare is not a charity. If the government subsidized it, we'd just pay more in taxes (and my property taxes, of which 50% goes to our schools, just went up by $1,000 for 2024). There's no miracle solution here since the govt can't just print more money.
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BurntCaregiver Dec 4, 2023
@Geaton

Is Teepa Snow going to provide the financial incentive for a homecare CNA to be at the top of their work class?

I don't think so. I an an APCNA (Advanced Practice Certified Nurse's Assistant) which is about the equal to an LPN or an LVN. I know my business and have a long homecare experience.
If a client's family ever requested that I watch Teepa Snow videos for instruction, my friend I would tell them to stick those videos where the "snow" don't fall and walk away.

It's not the worker's fault. Homecare agencies are like pimps. They don't care if the caregivers are poorly trained or trained at all so long as they bring that money in. A homecare agency will send a worker onto an assignment flying blind clueless of what to do or expect. Believe me there is no "support" available the agency for that aide either.
I was a homecare caregiver for 25 years. Calling the agency if you need help or when there's an emergency is worthless because they aren't going to do a damn thing. Every aide knows they're flying solo and on their own every time.

Now I have my own business, I go out and open every case personally. I also introduce the caregiver to the client and family myself. My caregivers can reach me any time. This is not how homecare agencies operate for the most part.
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I’ve had similar problems. It comes down to luck.

If you can afford private caregivers (not agency), go for it. Interview carefully. They all seem nice the first days. After a few weeks, you see the true nature. Use your gut.

Trust your gut.

The thing is, many hired caregivers became caregivers for the wrong reasons…opportunity to use/abuse the vulnerable elderly, scam them, steal…So it’s not surprising you’re bumping into incompetent caregivers, who just don’t care and can’t be bothered to improve.
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AndSoItGoes Dec 4, 2023
A background check would probably also be a good idea.

It does seem that a small but sinister fraction of HHAs go into this line of work with ill intent. Why roll the dice with shoplifting or B&E when you can just stroll around the home of a chair-bound person looking for opportunities.

HHA pay is atrocious. These folks are barely making enough just to sustain their toil.

More gov money should go to HHAs and less to hospitals charging tens of thousands of dollars for a single ER visit that does more harm than good, and that was compelled by a primary-care doctor (within same med system) too fearful of lawsuits to offer some basic support to a family trying to avoid hospitalization. (Sorry...wandered off on tangent there...)
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It is depressing. You are right. And most of the good money you pay goes to that agency, not the caregiver. So you can understand that with poor pay you don't get great quality workers. I am so sorry you have a hard time with this. My brother, in his ALF had MARVELOUS care. I can only think they got decent pay because they were all stellar. But that is rare today, and I think what you are experiencing is more the norm than not.
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Where I live HHAs are certified thru the State and like CNAs and are trained. They tend to do mostly cleaning cooking and laundry but overlap with CNAs and can do bathing and such. CNAs tend to do more hands on but overlap HHA in they do cleaning, cooking and laundry. Agencies are a business and there to make a profit. They pay the aides, the receptionist, the boss and overhead.
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I worked elder care for the 2 biggest companies in the nation. They are franchised out, so you get a very different 'training' and attitude from each one.

I was what you'd consider very overqualified for the job--but I needed flexible hours and had another job I was working around.

I was NEVER 'trained'. NEVER. Not even how to put a bandaid on.

I was paid $9 an hour and never received a raise. I worked holidays, weekends, whatever. I was lucky in that one of my families found out how little I was making and went to the company and worked out a 'private' raise for me so I was making closer to $15 an hour.

Many of the CG's don't have cars. Or licenses. Or clean records. Or don't speak the same language of their clients.

The turnover for any one client in the space of a year was 100%. Or super close to it. My client's family treated me like pure gold---b/c mom was a challenge and exhausting for the family. I loved her--but I got to go home at the end of the day.

Why is it so hard to get good workers? I would have to say that I never felt appreciated by my company, I was paid an abysmal amount of money and I was expected to be available 24/7.

I'm sure unimpressed with the CNA's that take care of my MIL. They've missed a lot of stuff and seem to be pretty poorly trained. Not my monkey, so I don't say anything.

Everyone complains about the money that is charged for in home care, but of that $39 an hour? Your CG is only getting about $12 of that.
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LilyLavalle Dec 3, 2023
I should have included that in my post. I called the company that my friend works for, was quoted $39/hour and asked why my friend only gets $15 ?(minimum here). I asked where does the other $24/ hour go? I mean I know they have overhead, insurance, etc., but more than double what the aid makes? The lady got very snotty with me.

To make matters worse my friend’s client has gotten progressively worse, to the point she should not be a home with an untrained aid. The level of care has increased dramatically, but my friend still gets minimum after 5 years!

These poor women are horribly taken advantage of. The good ones, like my friend, see it as a personal mission. She brings her client homemade cookies and does nice things for her. But I can see where others could get jaded and just do the bare minimum.
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Care.com is like hiring off the digital street. Like facebook or next door hires, a lot of these people are under the table pay wise or otherwise.
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I have contacted many agencies recommended to me by the hospital, rehab and hospice. None of them have certified aids. They are home health aids (HHA) rather than certified nursing assistants (CNA). Where I live the HHAs cost up to $39/hour! I can’t even imagine what a CNA would cost.

I have a couple of friends who are HHAs. Both of them are middle aged women who have raised families. I think they are both good at their jobs, but it is because they cared for children, handled emergencies, handled illnesses, made decisions, etc. Their training is life experience. I don’t think it would be out of line to request a mature, experienced woman from the agency. Good luck.
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These agencies should be hiring certified aids. Those who have taken a course and are certified by the State that they have passed this course. Sounds like they are hiring people off the street.

Care.com has been recommended here. Check with Jr. Colleges and Tech schools to see if they train aides and if so how can you hire one. If they have a Nursing program, is there someone who would likeva job. Neighborhood.com. Check with visiting nurse agencies to seevif they have a list of aides for hire. My job did.
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